Key result
A late invasive treatment strategy for patients presenting with anterior STEMI 48 to 72 hours after symptom onset was not superior to conventional medical therapy for short-term outcomes.
Why the study?
STEMI is treated using reperfusion to minimize infarct size and improve prognosis, but the comparative outcomes of a late invasive strategy versus medical therapy in anterior STEMI presenting within 48 to 72 hours were unclear.
Does delayed percutaneous coronary intervention improve in-hospital and three-month outcomes compared to conventional medical therapy in patients with anterior STEMI presenting 48 to 72 hours after symptom onset?
RCT (n=60)
closed envelop method
No
Does delayed percutaneous coronary intervention improve in-hospital and three-month outcomes compared to conventional medical therapy in patients with anterior STEMI presenting 48 to 72 hours after symptom onset?
Delayed percutaneous coronary intervention does not provide superior short-term outcomes compared to conventional medical therapy in patients with anterior STEMI presenting 48 to 72 hours after symptom onset.
Answers are grounded in this paper and cite their sources.
Late invasive strategy not supported for anterior STEMI at 48-72h; confirms no short-term superiority over medical therapy.
Background: ST-segment elevation myocardial infarction (STEMI) is now treated using reperfusion treatments that attempt to minimize infarct size and maximize patient prognosis. Aim of the Study: To evaluate the in-hospital and three-month outcomes of a late invasive treatment strategy vs a traditional medical therapy strategy in patients with anterior STEMI who present within 48 to 72 hours of symptom start. Materials and Methods: The current study was conducted at the cardiology department of the national heart institute and comprised 60 patients who presented to the emergency department with late anterior ST segment elevation myocardial infarction between 48 and 72 hours after symptom onset. The patients were randomly divided (closed envelop method) into two groups: Interventional Group (A): 30 patients who underwent primary PCI and medical Group (B): 30 patients treated with conventional medical therapy. Results: No significant distinction was detected between both groups regarding in-hospital MACE, ejection fraction, CKMB serial levels, MACE and ejection fraction and MPI (LAD territory) at three months follow up. Conclusion: A late invasive treatment method for patients presenting between 48- and 72-hours following symptom onset with anterior STEMI is not superior to a conventional medical treatment strategy and has similar efficacy and short-term outcomes.
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Elmagd et al. (2023) conducted an RCT in Anterior ST Segment Elevation Myocardial Infarction (n=60). Late invasive treatment strategy (primary PCI) vs. Conventional medical therapy was evaluated on In-hospital and 3-month MACE, ejection fraction, CKMB serial levels, and MPI. A late invasive treatment strategy for patients presenting with anterior STEMI 48 to 72 hours after symptom onset was not superior to conventional medical therapy for short-term outcomes.
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